The term precision health means different things to different people. Most experts agree, however, that the path to true precision health means unlocking siloed data, understanding the whole patient story and using a team-based approach to address patient needs.
On Sept. 1, speakers discussed precision health and prescribing during the second day of the Precision Health Virtual Summit hosted by hc1 and Becker's Hospital Review. The event was sponsored by Quest Diagnostics, Snowflake, and AWS.
Presenters were:
- Mike Lukas, vice president and general manager, health systems, Quest Diagnostics
- Jeffrey Kuhlman, MD, general manager, healthcare analytics solution, Advent Health in Altamonte Springs, Fla.
- Katherine Capps, co-founder & executive director, GTMRx Institute
- Jennifer Hockings, PharmD, PhD, pharmacogenomics clinical specialist, Department of Pharmacy and Center for Personalized Genetic Healthcare (CPGH), Cleveland Clinic
- Gilan El Saadawi, MD, PhD, founder and chief medical officer, Realyze Intelligence
- Behnaz Sarrami, PharmD, medical science liaison, AltheaDx
- Kandace Schuft, PharmD, senior clinical content specialist, pharmacogenomics, Wolters Kluwer Clinical Drug Information
- Anthony Morreale, PharmD, associate chief consultant for clinical pharmacy services and policy, U.S. Department of Veterans Affairs
- Richard Peters, MD, assistant professor of population health and technology lead, health ecosystem, University of Texas in Austin
- Todd Crosslin, global head of healthcare and life sciences, Snowflake
- Brad Bostic, Chairman and CEO, hc1
Five insights from the second day of the Precision Health Virtual Summit:
- Precision health requires us to focus on the whole patient story. Although physicians have access to digital tools and mountains of data, those fail to provide a unified patient story. "Genomics and pharmacogenomics are a high-value data point, but I would argue that we are looking at it as the next shiny object that will solve our problems. It's only one part of the patient's story," Dr. Saadawi said. Other important elements include environmental factors, comorbidities, social determinants of health and ethical considerations.
- Fragmented information is a barrier to precision health. Clinicians are faced with many disparate sources of information ranging from EMRs to imaging data, genomics and pharmacogenomics and more. "We're getting more data, but how much information is enough to tell us that a particular type of precision medicine is good enough to change the existing standards of care?" Dr. Saadawi asked.
- To understand the patient story, providers need a platform that goes beyond the EHR. In addition to the structured EHR data, clinicians need access to unstructured data like documentation from physicians, nurses or social workers. This enriches the patient story with goals of care and the patient's health concerns. Out-of-network information is also crucial, such as genomic test results, pharmacogenomics and personalized data from patient wearables. "The only way we can reach a patient's story is to build a platform that includes all of this information," Dr. Saadawi explained.
- Precision health means individualizing medication regimens to improve patient outcomes. Each patient has unique needs and a one-size-fits-all approach to pharmacotherapy is less than optimal. "When pharmacists work closely with the patient and other healthcare providers, they can assess a patient's pharmacokinetic, pharmacodynamic and pharmacogenomic variables to select the right treatment the first time, rather than the trial-and-error approach which has been the hallmark of medicine in the past," Dr. Morreale said.
- Team-based care can make precision care a reality, while reducing physician administrative burden. The U.S. Department of Veterans Affairs has been on an 11-year journey to implement team-based care. Medical home teams consist of physicians, nurses, psychologists, dietitians and social workers. "If a patient's disease isn't controlled, it isn't always a pharmacotherapy issue," Dr. Morreale said. "It could be dietary or the fact that a person is homeless. Providers have a choice of team members to assist the patient and that support team has led to tremendous improvements in care." The VA significantly outperforms the private sector on HEDIS measures, due in large part to strong team-based care. The team approach has also reduced cleric burden and improved job satisfaction among VA physicians, since work can be shifted to clinical pharmacists and other specialists.
To view the full sessions from Day 2 of the Precision Health Virtual Summit on-demand, click here. To learn more about hc1, click here.